Provider Demographics
NPI:1710717624
Name:CARPENTER, YANEIDY ISABEL (APRN)
Entity type:Individual
Prefix:
First Name:YANEIDY
Middle Name:ISABEL
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:YANEIDY
Other - Middle Name:
Other - Last Name:ESCOBAR GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:380 RINEHART RD
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-2551
Mailing Address - Country:US
Mailing Address - Phone:321-843-2100
Mailing Address - Fax:321-842-3498
Practice Address - Street 1:380 RINEHART RD
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2551
Practice Address - Country:US
Practice Address - Phone:321-843-2100
Practice Address - Fax:321-842-3498
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11035476363LA2200X
FL11035476363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL124165000Medicaid